5th IAS Conference on HIV Pathogenesis, Treatment and Prevention, 19-23 July 2009, Cape Town

30 December 2009. Related: Conference reports, Conference index, IAS 5th Cape Town 2009.

Introduction

Polly Clayden, HIV i-Base

We conclude our reports from this important conference with the following paediatric studies.

Reports from the conference.

• Early infant diagnosis

• Difficulties with implementation

• Infant outcomes

• Improved neurodevelopmental outcomes

• Treating children exposed to single dose nevirapine for PMTCT

• Using a nevirapine-containing fixed dose combination in the CHAPAS trial

• Once a day lamivudine and abacavir, and abacavir hypersensitivity in the ARROW trial

A wealth of paediatric data was presented at IAS 2009 held in Cape Town in July. Also preceding the conference was the 1st International Workshop on HIV Pediatrics, which looks as if it will become an annual fixture on the conference calendar and gave an additional opportunity to present and discuss the state of the art in the field.

Overall, far too much was presented to review here. Abstracts, some slides and, for IAS2009, webcasts can be viewed on the respective conference websites.

Several themes occurred over and over again at both meetings.

National capacity for early infant diagnosis, which not only enables early initiation of treatment but also gives a clearer picture of how well prevention of mother-to-child transmission (PMTCT) programmes are performing, with the goal of vastly reducing cases of paediatric HIV, is not yet nearly sufficient in most places.

Where infants are diagnosed in time, early initiation of treatment is not without its difficulties. It can, however, be extremely beneficial in young children.

Treatment of children who are HIV-infected despite exposure to single-dose nevirapine through PMTCT is another challenge, as is what to do in the longer term with exposed children initiated on a protease inhibitor-containing HAART to overcome the risks of NNRTI resistance.

Strategies to simplify regimens, including paediatric fixed-dose combinations and once-a-day dosing, are essential for successful management of children with HIV, as are strategies to enable co-treatment of tuberculosis in this population.

The research summarised below addresses these issues.